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What Does a Doula Do?
If you’re expecting a new baby, you may have been given the advice to hire a doula. You may have seen statistics of improved outcomes among those who’ve had a doula attend their birth. Perhaps you’ve heard that the etymology is from the Greek word meaning “to serve.” But how does a doula serve their clients? A doula is a non-medical birth professional who will guide you through labor, birth, postpartum and beyond. Your doula can discuss your options with you so you can make informed decisions, as well as provide emotional and physical support to ease your experience. While each doula offers their own style, there are certain services that most doulas will provide for their clients. Typically, a birth doula will provide at least one prenatal visit, one postpartum visit and continuous support during active labor. A postpartum doula usually provides support during the 12 weeks immediately following birth, sometimes referred to as the “fourth trimester,” but some will continue care after that as well. Simply put, a doula provides informational, physical and emotional support during the childbearing year(s). Let’s take a closer look at these three ways a doula can support you. The Basics If you don’t know your options, you don’t have any. This is a common phrase in the world of birth work. When you’re in labor, you’re exhausted, in pain and there’s often urgency inherent or implied in any choices you make. So, when an intervention is offered, many birthing people accept it without question. One method that can help the decision-making process is to check your BRAIN: Benefits: What are the benefits of the proposed intervention? Risks: What are the risks of the proposed intervention? Alternatives: What are the alternative options? Intuition: What does your intuition tell you? Nothing: What if we do nothing? What if we wait? When you’re in active labor, you might have difficulty remembering this acronym; that’s where your doula comes in. At your prenatal visits, you can ask your doula for guidance in preparing your birth plan, which can include contingencies for certain potential interventions. And as choices arise during labor, your doula can guide you through the benefits and risks and can provide you with alternative options you might not otherwise be aware of that are available to you. Your doula can remind you to check in with your intuition and can help you quiet your mind so you can listen to your instincts. The Body Although we tend to see depictions of people giving birth on their backs with their feet in stirrups, this is only one of many ways to give birth. Walking and dancing can speed up early labor. Side-lying or hands-and-knees can prevent tearing during the pushing stage. Sometimes labor stalls, and a change of position is often helpful to get things moving again. Your doula can suggest positions depending on your stage of labor. Some labor positions might require the support of another person – your doula could fill this role or assist your partner in doing so. Some doulas also provide massage or even acupressure, and most will do the “hip squeeze” that so many laboring people swear by. If your baby is presenting posterior, or “sunny side up,” your doula can apply counter pressure to alleviate back pain during labor. Some postpartum doulas will do light housework while you rest and bond with your newborn. Others might care for your baby through the night so you can catch up on sleep. Many doulas have also gone through additional training to offer breastfeeding support and may be able to assist you with latch issues and nursing positions. The Mind Pregnancy, birth and postpartum periods can be some of the most emotional times in a person’s life. A doula will hold space for you and help you process your emotions before and after birth. It’s normal to feel apprehensive, or even fearful, about labor and birth, and discussing these feelings is the first step. A doula can help you navigate your concerns in a safe space so you can be prepared emotionally for your upcoming labor. Many doulas will also guide you through writing your birth plan, which can lessen anxiety about the unknown. If you have a history of trauma, your doula can assist in communicating this, so you don’t have to relive the experience every time you meet a new medical provider. Most people will experience some form of what’s often called the Baby Blues in the immediate postpartum period. The third day after birth tends to hit hard, as hormones attempt to regulate, but the Baby Blues can continue for weeks for some new parents. A postpartum doula’s support can be incredibly valuable during this time. When the baby blues last longer than a few weeks, it could considered a mood disorder. Most doulas will recognize signs of postpartum mood disorders and will have resources available for additional support. Choosing the Best Doula for You With so many wonderful doulas in northern Nevada, you might wonder how you could ever choose just one to attend your birth. Some expectant parents are unfortunately restricted by cost. With so many expenses related to a new baby, it can be difficult to budget doula services as well. Thankfully, Nevada Medicaid now covers doula care, and some commercial insurances are following suit. Check with your insurance company to find out if they might cover part of the cost for hiring a doula. If your insurance doesn’t cover doula services, some doulas offer a sliding scale based on income. You may want to interview multiple doulas to find the right one for you. If you’re the kind of person who wants all the information you can get, a more detail-oriented doula might be the best choice. But if you tend to feel overwhelmed by too many options, you might prefer a doula who only offers additional information as the situation calls for it. If you want massage or acupressure during labor, you might want to hire a doula with those certifications. Or maybe informational and physical support are not as important to you as emotional support, in which case your best choice could be a doula who has experience with postpartum mood disorders or trauma support. Regardless of who you hire, be sure to clearly communicate your desires and expectations – not just for your birth, but also for your doula. The most important thing when choosing your doula is trusting your gut. You need to feel comfortable with your doula, as they’ll be tending to you at one of the most vulnerable times in your life. When you find a doula that you click with, who listens to you and supports your choices, you have found the best doula for you.
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Renown Health Pulmonary Rehabilitation Program Certified by American Association of Cardiovascular and Pulmonary Rehabilitation
Renown Health is proud to announce the certification of its pulmonary rehabilitation program by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). This certification is recognition of Renown Health’s commitment to improving the quality of life of patients by enhancing standards of care. Pulmonary rehabilitation programs are designed to help people with pulmonary problems (e.g., chronic obstructive pulmonary disease [COPD], respiratory symptoms, long COVID-19) recover faster and live healthier. Both programs include exercise, education, counseling and support for patients and their families. According to the Center for Disease Control and Prevention, COPD impacts 16 million people across the United States, and 1 in 13 adults (7.5%) have “long COVID” symptoms, defined as symptoms lasting three or more months after first contracting the virus, and that they didn’t have prior to their COVID-19 infection. "We are thrilled to receive this certification from the American Association of Cardiovascular and Pulmonary Rehabilitation for our pulmonary rehabilitation program at Renown South Meadows Medical Center. This recognition underscores Renown Health's unwavering dedication to providing the highest standards of care and improving the lives of our patients, no matter what life throws at them,” said Sam Weller, MHPA CEO of Renown South Meadows Medical Center and Renown Rehabilitation Hospital. “Our commitment to excellence shines through in every aspect of our programs, and this certification reinforces our ongoing mission to make a positive impact on the health and well-being of the people of northern Nevada." To earn this accreditation, Renown Health’s pulmonary rehabilitation program participated in an application process that requires extensive documentation of the program’s practices. AACVPR Program Certification is the only peer-review accreditation process designed to review individual programs for adherence to standards and guidelines developed and published by AACVPR and other related professional societies. Each program’s application is reviewed by the AACVPR Program Certification Committee, and certification is awarded by the AACVPR Board of Directors. "At Renown Health, our pulmonary rehabilitation program is designed with our patients in mind. Our focus includes physical exercise, extending to education, counseling and support for both patients and their families,” said John Lynn, Manager of Respiratory Services at Renown Health. “This AACVPR certification is a testament to our team's hard work and dedication in ensuring that individuals with pulmonary conditions receive the best possible care to enhance their quality of life." In 2018, AACVPR moved to an outcomes-based process with performance measurements that represent more meaningful outcomes. Therefore, AACVPR-certified programs are leaders in the cardiovascular and pulmonary rehabilitation field because they offer the most advanced practices available and have proven track records of high-quality patient care. AACVPR Program Certification is valid for three years. About Renown Health Renown Health is Nevada’s largest, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination, and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the locally owned not-for-profit insurance company, Hometown Health. Renown is currently enrolling participants in a community-based genetic population health study, the Healthy Nevada Project®. About AACVPR Founded in 1985, the American Association of Cardiovascular and Pulmonary Rehabilitation is a multidisciplinary organization dedicated to the mission of reducing morbidity, mortality and disability from cardiovascular and pulmonary disease through education, prevention, rehabilitation, research and disease management. Central to the core mission is improvement in quality of life for patients and their families.
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El Programa de rehabilitación pulmonar Thomas S. Dolan recibe una certificación respetada del líder de la industria
The program becomes first of its kind to be accredited in Nevada. Renown Health is pleased to announce the certification of the Thomas S. Dolan Pulmonary Rehabilitation program at Renown South Meadows Medical Center by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). AACVPR certification demonstrates that an organization's Pulmonary Rehabilitation Program is aligned with current guidelines set by the American Association of Cardiovascular and Pulmonary Rehabilitation for appropriate and effective early outpatient care of patients with cardiac or pulmonary issues. Certification offers peace of mind, so that patients can feel confident in knowing that staff has the experience and skills necessary to coordinate the many issues faced by people receiving a life-changing cardiac or pulmonary diagnosis. Pulmonary rehabilitation programs help people with health issues such as asthma, chronic bronchitis, pulmonary fibrosis, or chronic obstructive pulmonary disease (COPD) recover faster and live healthier. “Having access to quality pulmonary rehabilitation services so close to home, staffed by a highly-skilled group of compassionate care providers, truly is a gift to our community,” said Tony Slonim, MD, DrPH, president and CEO of Renown. “Estamos muy orgullosos del trabajo que se realiza en nuestro programa de rehabilitación pulmonar, y también estamos eternamente agradecidos por la donación de Tom Dolan al programa en 2019, que permite a los residentes de Nevada mejorar su salud y su calidad de vida”. “El Programa de rehabilitación pulmonar Thomas S. Dolan es el único programa de rehabilitación pulmonar acreditado en el estado de Nevada”, señaló Chris Nicholas, vicepresidente de Renown South Meadows Medical Center and Rehabilitation Hospital. “We take pride in this distinguished honor from the AACVPR as it acknowledges and amplifies the life-changing work happening here. Our dedicated caregivers provide support to our patients every step of the way, helping them lead vibrant and fulfilling lives despite their health conditions.” The comprehensive pulmonary rehabilitation program at Renown South Meadows Medical Center offers treadmills, stationary bicycles, strength training and an education classroom to help patients achieve health goals. To earn accreditation, Renown’s pulmonary rehabilitation program participated in an application process requiring extensive documentation of the program’s practices. La certificación de programas de la AACVPR es el único proceso de acreditación de revisión por pares diseñado para revisar los programas individuales conforme al cumplimiento de las normas y las pautas desarrolladas y publicadas por la AACVPR y otras asociaciones profesionales relacionadas. En noviembre de 2019, Tom Dolan propietario y fundador de Dolan Auto Group, realizó una donación al Programa de rehabilitación pulmonar de Renown South Meadows Medical Center después de que su experiencia personal en la rehabilitación pulmonar le hiciera percatarse sobre las capacidades y necesidades que había en el norte de Nevada. His generous donation has allowed Renown to double the number of patients who receive treatment and increase the access to pulmonary rehab in our community. “As a former patient myself, I found so much benefit in my pulmonary rehab,” said Dolan. “I have always wanted to support this program and increase the number of people it serves. It’s great to see that we now have the only certified pulmonary rehab in Nevada.” “The most essential component of lung health is breaking the cycle of inactivity associated with lung disease,” said Lung Critical Care Physician Dr. Farah Madhani-Lovely. “Our community is fortunate to have an accredited program like this to empower our patients.” About Renown Health Renown Health is the region’s largest, locally owned and governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. Con una fuerza laboral diversa de más de 7,000 empleados, Renown ha fomentado una cultura de excelencia, determinación e innovación de larga data. La organización se compone de un centro de urgencias, dos hospitales de cuidados agudos, un hospital infantil, un hospital de rehabilitación, un grupo médico y una red de atención de urgencias y Hometown Health, la compañía de seguros sin fines de lucro más grande de la región y de propiedad local, Hometown Health. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Heath, Neurosciences and Robotic Surgery. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project® . Para obtener más información, visite renown.org. Acerca de la AACVPR Fundada en 1985, la American Association of Cardiovascular and Pulmonary Rehabilitation es una organización multidisciplinaria dedicada a la misión de reducir la morbilidad, la mortalidad y la discapacidad causadas por las enfermedades cardiovasculares y pulmonares a través de la educación, la prevención, la rehabilitación, la investigación y el control de las enfermedades. Central to the core mission is improving the quality of life for patients and their families. Obtenga más información sobre la AACVPR en www.aacvpr.org.
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Donde hay humo, puede haber más dolores de cabeza, náuseas y tos
El equipo de Renown Urgent Care lo prepara para mantenerse a salvo esta temporada y está disponible los siete días de la semana en 11 ubicaciones del norte de Nevada. Millones de personas en todo el oeste viven en zonas donde la contaminación atmosférica puede causar graves problemas de salud. Local air quality can affect our daily lives. Like the weather, it can change from day to day. The Northern Sierra Air Quality Management District issued an Air Quality Health Advisory for Plumas County, to notify the public of the possibility of poor air quality conditions resulting from the Beckwourth Complex Fire in addition to other wildfires in northern California. In addition, there is the potential for wind shifts to carry smoke to other parts of Plumas County from the Beckwourth and several other regional wildfires. Air quality is expected to vary greatly depending on fire behavior and weather conditions, with smoke settling in low areas at night and in the early mornings as long as these fires are active. The advisory mentions, “Exposure to elevated PM2.5 (fine particulate matter in smoke) concentrations can result in eye and throat irritation, headaches, nausea, shortness of breath, congestion, coughing, impaired lung function and chest pain, especially among sensitive individuals such as the elderly, children, people with asthma, people with heart or lung conditions, pregnant women and anyone who is exercising or working hard outdoors.” Kouros Farro, MD, a physician with Renown Urgent Care advises that there are people who are more likely to be affected when fine particle pollution reaches an unhealthy level. People who have asthma or other breathing conditions like chronic obstructive pulmonary disease (COPD). People who have heart disease or high blood pressure. Children and older adults. People of all ages who are doing extended or heavy, physical activity like playing sports or working outdoors. “Everyone should take precautions when the air quality is unhealthy. Air pollution can aggravate heart and cardiovascular disease as well as lung diseases like asthma and COPD. When the air quality is unhealthy, people with these conditions may experience symptoms like chest pain, shortness of breath, wheezing, coughing, or fatigue. Si experimenta alguno de estos síntomas, use sus inhaladores según las indicaciones y comuníquese con su proveedor de atención médica”, recomienda el Dr. Farro, que está certificado por el consejo en medicina familiar y ejerce en Renown Urgent Care en 975 Ryland St, Reno. “If you do not have a health care provider, know we have a Renown Urgent Care office on almost every corner, with providers ready to see you.” Dr. Farro advises the following: Take it easy and listen to your body. Limit, change, or postpone your physical activity level. If possible, stay away from local sources of air pollution like busy roads and wood fires. If you have asthma or other breathing conditions like COPD make sure you have your relief/rescue inhaler with you. People with asthma should review and follow guidance in their written asthma action plan. Make an appointment to see your health provider to be sure you have an asthma action plan. “Even just one hour of smoke exposure can affect our lungs and hearts, and these consequences can reach people far beyond the direct area endangered by the fire. Children, older adults, pregnant women, people with preexisting cardiopulmonary disease, communities of color, economically disadvantaged communities, and people with preexisting chronic health conditions like asthma, diabetes, and obesity are all especially vulnerable to the air pollution that wildfires cause," says Dr. David Lemak, Division Chief of Urgent Care at Renown. Renown Urgent Care brinda tratamiento para una amplia gama de lesiones, enfermedades e inquietudes médicas leves que son urgentes, pero no suponen un riesgo para la vida y que requieren atención médica en el mismo día. También le evita los tiempos de espera prolongados y los altos precios de la sala de emergencias en los 11 centros convenientes, incluidos Reno, Sparks, Carson City, USA Parkway, Fallon y Fernley. You can walk-in or book ahead online. You can get the latest fire and smoke information at the Washoe County Health District’s Be Smoke Smart webpage. It includes information about air pollution levels and how to protect yourself from the smoke. An on-line subscription page allows you to sign up for EnviroFlash, notifying you about air quality. Acerca de Renown Health Renown Health es una red de atención médica integrada de administración local y sin fines de lucro que brinda servicios al norte de Nevada, Lake Tahoe y el noreste de California. Renown es uno de los mayores empleadores privados de la región y cuenta con una fuerza laboral de más de 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown has a long tradition and commitment to continually improve the care and the health of our community. Visite renown.org para obtener más información.
Leer más About Donde hay humo, puede haber más dolores de cabeza, náuseas y tos
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El humo de los incendios forestales es más peligroso que cualquier otro tipo de contaminación atmosférica para las personas con asma
El Índice de calidad del aire de fase 2 y los alarmantes estudios de investigación del DRI, Renown Health y el Distrito de Salud del Condado de Washoe conducen a un aviso de salud pública; se debe buscar atención médica si es necesario. Para las personas que padecen asma, el humo de los incendios forestales es más peligroso que cualquier otro tipo de contaminación atmosférica, según un estudio del Desert Research Institute (DRI), el Renown Institute for Health Innovation (Renown IHI) y el Distrito de Salud del Condado de Washoe (WCHD). El estudio publicado en la revista Environmental Health examinó las asociaciones entre las partículas en el aire (particulate matter, PM) procedentes de fuentes como los incendios forestales, el transporte y la industria, y las visitas médicas por asma en los departamentos de emergencia y centros de Urgent Care de Renown Health en Reno, Nevada, durante el período de seis años comprendido entre 2013 y 2018. In places like Reno, where wildfire events occur regularly during parts of the year and are expected to become more frequent in the future, an accurate understanding of the impacts of wildfire smoke on population health is critical. We have an exceptional process in place through our urgent care sites, Renown Medical Group offices and hospital emergency departments to screen, diagnose and treat members of our community who come to us for care related to asthma, chronic obstructive pulmonary disease (COPD), chronic bronchitis, emphysema, and other upper respiratory diseases that may be exacerbated by wildfire smoke. At the same time, we continue to develop and refine, in real-time, the data that supports our predictive analytic models. We are using every tool and resource-including scientific data and clinical reporting, to ensure that we are meeting both the health and healthcare needs of the people we serve. En el estudio, los investigadores descubrieron que la calidad del aire en el área de Reno se vio afectada por el humo de los incendios forestales en un total de 188 días durante el periodo del estudio. En total, se produjeron 18,836 visitas a la sala de emergencias y atención de urgencia relacionadas con el asma durante el mismo período de cinco años, lo que indica que es importante comprender la influencia del humo de un incendio forestal y otros tipos de contaminación atmosférica en esta afección médica. La Air Quality Management Division (AQMD) del Distrito de Salud del condado de Washoe ha emitido una advertencia de contaminación del aire de fase 2 debido al humo de los incendios en el área. La calidad del aire en el área de Reno-Sparks ahora es “muy poco saludable” y tiene un Índice de calidad del aire de 247. La advertencia de fase 2 significa que todos los residentes deben permanecer en sus residencias y reducir los niveles de actividad debido a la susceptibilidad de mayores riesgos para la salud. To see current air quality in Reno-Sparks, click here. Brion Hill, MD who practices at the Renown Urgent Care - Los Altos location warns, “This is an important health advisory, exposure to elevated PM2.5 (fine particulate matter in smoke) concentrations can result in eye and throat irritation, headaches, nausea, shortness of breath, congestion, coughing, impaired lung function and chest pain. Everyone should take precautions when the air quality is unhealthy. Air pollution can aggravate heart and cardiovascular disease as well as lung diseases like asthma and COPD. When the air quality is unhealthy, people with these conditions may experience symptoms like chest pain, shortness of breath, wheezing, coughing, or fatigue. If you are experiencing any of these symptoms, use your inhalers as directed and contact your health care provider,” says Dr. Hill. “Si no tiene un proveedor de atención médica, tenemos 11 consultorios de Renown Urgent Care convenientemente ubicados con proveedores listos para atenderlo los 7 días de la semana”. Dr. Joseph Grzymski, a research professor at Desert Research Institute, a corresponding author on the study and Chief Scientific Officer, Renown Health, says, “This air is very bad for your health. Given today’s Air Quality Index in Reno, being outside and breathing this air for a day equals about smoking half a package of cigarettes.” Información adicional: The full text of the article “Particulate matter and emergency visits for asthma: a time-series study of their association in the presence and absence of wildfire smoke in Reno, Nevada, 2013–2018” (Partículas en el aire y visitas de emergencia por asma: un estudio de series temporales de su asociación en presencia y ausencia de humo de incendios forestales en Reno, Nevada, entre y ) está disponible en Environmental Health: https://ehjournal.biomedcentral.com/articles/10.1186/s12940-020-00646-2 Para obtener más información sobre el Renown Institute for Health Innovation, visite: https://www.dri.edu/renown-ihi/ Renown Urgent Care brinda tratamiento para una amplia gama de lesiones leves, enfermedades e inquietudes médicas que son urgentes, pero no suponen un riesgo para la vida y que requieren atención médica en el mismo día. También le evita los tiempos de espera prolongados y los altos precios de la sala de emergencias en los 13 centros convenientes, incluidas Reno, Sparks, Carson City, USA Parkway, Fallon y Fernley. You can walk-in or book ahead online. The Washoe County Health District offers online health information on its Be Smoke Smart website, including fire information, daily air quality information, fire and smoke maps and how to protect yourself. About the Desert Research Institute The Desert Research Institute (DRI) is a recognized world leader in basic and applied interdisciplinary research. Committed to scientific excellence and integrity, DRI faculty, students, and staff have developed scientific knowledge and innovative technologies in research projects around the globe. Desde 1959, la investigación del DRI ha profundizado el conocimiento científico, ha apoyado la diversificación de la economía de Nevada, ha proporcionado oportunidades educativas científicas y ha informado a legisladores, líderes empresariales y miembros de la comunidad. With campuses in Reno and Las Vegas, DRI serves as the non-profit research arm of the Nevada System of Higher Education. Para obtener más información, visite www.dri.edu. Acerca de Renown Health Renown Health es una red de atención médica integrada de administración local y sin fines de lucro que brinda servicios al norte de Nevada, Lake Tahoe y el noreste de California. Renown es uno de los mayores empleadores privados de la región y cuenta con una fuerza laboral de más de 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown tiene una larga trayectoria y un compromiso de larga data con la mejora de la atención y la salud de nuestra comunidad. Visite renown.org para obtener más información.
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Meet Multifaceted Member Don Chang
Renaissance Don The Sterling Silver Club is honored to have thousands of members who’ve led and continue to lead incredibly vibrant and diverse lives. And we’re absolutely thrilled when those members volunteer to share their stories and experiences so we can all appreciate and learn from them. This issue’s featured member is no exception. From his love of cooking, travel and music to his drive to learn new languages, take on new hobbies and keep himself active and fit, Don is an aspiring Renaissance man who may already be deserving of the title. Revolutionary Family Roots Don’s father, who was born in Beijing, China, earned a master’s degree in metallurgical engineering from the University of California, Berkeley and was working on his PhD there on a full scholarship from his home country when the Chinese Communist Revolution occurred. In order to stay in the United States and avoid potentially being thrown into prison by the new communist regime (a fate that befell some of his family members), his father married Don’s mother, who was a U.S. citizen and also a student at Berkeley. Together, they started a family. “My father met my mother in a class and received his green card by marrying her,” says Don. “They proceeded to have six kids in nine years, I was number three. Dad never finished his PhD, but clearly earned what we like to call his “PSK” degree – Papa with Six Kids.” Proud (of) Papa: Don’s father was a professor of metallurgy and a brilliant research scientist who was responsible for virtually every breakthrough in the development of titanium in the 1960s.